Gestational Diabetes: What to Do About a High Fasting Blood Sugar
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Gestational diabetes mellitus (GDM) is diabetes that develops in pregnancy. It can often be managed with lifestyle changes such as increasing exercise and eating fewer carbohydrates. For more information about what gestational diabetes is, check out one of my previous blog posts. Today I’m going to focus specifically on how to lower morning blood sugar levels with lifestyle changes.
What is fasting blood sugar?
With a diagnosis of gestational diabetes, it is important to test blood sugar levels at home each day. Fasting blood sugar needs to be taken each morning, with at least 8 hours since the last bite of food or drink (other than plain water). ACOG (American College of Obstetricians and Gynecologists) recommends a fasting blood sugar of less than 95 mg/dL.
Increasing hormone levels in pregnancy can make it more challenging for the body to produce enough insulin to keep blood sugars in the desired range. There are many factors that influence fasting blood sugar that are not related to food choices, such as:
Activity level - being sedentary can cause higher blood sugars
Illness or injury - being sick or hurt can make blood sugars higher
Sleep patterns - not sleeping well or enough can increase blood sugars
Stress level - high stress can lead to elevated blood sugar readings
High fasting blood sugar can lead to a bigger baby, which increases the likelihood of complications during delivery or the need for an earlier delivery or c-section.
How to lower fasting blood sugar
There are several lifestyle modifications to try before turning to medication to lower fasting blood sugar levels:
Avoid eating dinner too late. I recommend eating dinner at least 3-4 hours before you plan to go to bed, if possible.
Avoid eating too many carbohydrates at dinner. Aim for no more than 30-45 grams of high-fiber carbs with your dinner, examples include quinoa, beans, lentils, sweet potato with the skin, and whole grain pasta. Pairing carbs with a protein source and lots of veggies is also important and can minimize post-dinner blood sugar spikes. Read this post for more information about carbs!
Walk or do some other type of exercise for at least 15-20 minutes after dinner. Do something that gets your heart pumping!
Eat a high-protein and low-carb snack before going to bed. Examples include a spoonful of peanut butter, a handful of nuts or seeds, a string cheese, cottage cheese with tomato, or plain Greek yogurt. You may be able to experiment with adding a little bit of carb to this snack, but try to keep it at 10 grams of carb or less. 10 grams of carb is equivalent to 3 Triscuit crackers or 1/2 cup of blueberries.
Try to get enough sleep! It can be challenging to sleep well while pregnant, but getting at least 7-8 hours of sleep each night may improve fasting blood sugar levels.
Find ways to manage stress, as this also may help lower fasting blood sugars.
For more food-specific information, check out this book.
What if fasting blood sugar remains high despite lifestyle changes?
Sometimes, no matter what changes you make to lower fasting blood sugar, it still remains high. It can be frustrating if only the fasting blood sugar is high, while blood sugars after meals are in the normal range, but it is common. When this happens, medication is often needed to lower blood sugar; an insulin injection at bedtime is the preferred medication but there are also oral medication options. Talk with your doctor about options for medications.
The good news with a diagnosis of gestational diabetes is that it can be managed! A high fasting blood sugar can be frustrating, but increasing your activity level before bed, making sure you get enough sleep, managing stress, and modifying your dinner and/or bedtime snack may help reduce your morning blood sugars. And the more in control your blood sugars are during pregnancy, the lower your risk for developing type 2 diabetes later in life. If you have or have had gestational diabetes and want more individualized recommendations for controlling your blood sugars, schedule a free 15-minute call with me today!
